Raven Adams
Individual provider Active NPI Family Medicine Physician · Philadelphia, PA
NPI 1902434582 · NPPES record last updated Feb 13, 2025
Key facts
- NPI
- 1902434582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- OS024294 (PA)
- Practice address
- 5501 Old York Rd
Philadelphia, PA 19141-3018 - Phone
- (215) 456-7170
- Fax
- (215) 456-4923
- NPI assigned
- Mar 30, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250217003080 | PA | Practitioner - Pediatric Medicine | 0749607059 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS024294 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Einstein Practice Plan Inc | Current | Accepting new patients | |
| Einstein Practice Plan Inc | Current |
Accepting new patients | |
| Einstein Practice Plan Inc | Current |
Accepting new patients | |
| Einstein Practice Plan Inc | Past | Accepting new patients |
Locations
5501 York Rd
Ste 1
Philadelphia, PA 19141
Phone (215) 456-6500
5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405
101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630
5501 Old York Rd
Ste 2
Philadelphia, PA 19141
Phone (215) 456-7130
Interoperability endpoints
- radams69241@uihealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | OS024294 | PA | Yes |
Addresses
Primary practice location
5501 Old York Rd
Philadelphia, PA 19141-3018
Mailing address
101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-1825
Other practice location 1
1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273
Other providers in Philadelphia, PA
- Morgan Adams
- Natalie Adams
- Natasha Shante' Adams
- Niamh Catherine Adams
- Nicholas Adams
- Ronell Capree Adams
- Ruth C Adams
- Sarah Adams
- Sarah F Adams
- Sarah Laura Adams
All providers in Philadelphia, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.